Global vaccine equity key to ending COVID-19 pandemic

As the COVID-19 crisis continues around the world, public health and infectious disease experts at Western University's Schulich School of Medicine & Dentistry are pushing for global vaccine equity to end the pandemic.

In a new editorial published in the International Journal of Public Health, co-authors Shehzad Ali, Michael Clarke, Dr. Michael Silverman and Dr. Saverio Stranges called on the Canadian government to adopt legislation and policies that will improve global vaccine equity to mitigate the potential risks of future variants developing.

Formal mechanisms exist for suspending patent protection for medicines in the event of a national or global emergency, including issuing an intellectual property waiver or compulsory licenses for generic drug production, the experts explained in their piece, "Global Vaccine Equity to End the COVID-19 Pandemic: A Canadian Perspective and Call to Action."

This would allow for the production of patented vaccines by generic pharmaceutical companies at a lower cost.

"The current COVID-19 pandemic and the obviously skewed and unjust global distribution of vaccines represent solid grounds for employing a compulsory license or waiver for the generic manufacture of vaccines," said Stranges, chair of the department of epidemiology and biostatistics. "The legal and legislative processes are in place for Canada to do the right thing. Donations of vaccines from high-income countries may alleviate inequity in the short term. However, the establishment of locally owned vaccine manufacturing capacity in low- and middle- income regions, lessening their dependence on donor funding, is a more sustainable option in the longer term."

According to data from the United Nations Development Program's Global Dashboard for Vaccine Equity, about 67.53 percent of people in high-income countries have received at least one dose of COVID-19 vaccine as of Jan. 26, 2022. That compares with just 11.18 percent having received at least one dose in low-income countries.

The World Health Organization's COVAX program has delivered only one-seventh of the commitments from high-income countries as of December 2021. Canada has drawn nearly one million doses from the program and has delivered only 3.2 million of the 40 million doses it promised.

"Canada has legislation in place that would enable the manufacture and distribution of patented vaccines through compulsory licenses or an intellectual property waiver," explained Clarke, adjunct professor in the Master of Public Health Program at Schulich Medicine & Dentistry.

Canada was the first country in the world to use this legislation, the Canada Access to Medicines Regime, in 2006, which implemented specific exceptions under the World Trade Organization's Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement. The mechanism was used to manufacture and distribute an anti-HIV drug in response to a request from Rwanda.

Clarke said that legislation needs to be refined and integrated for Canada to "re-establish its global leadership in the provision of essential medicine."

The group added compulsory licenses and intellectual property waivers are not the sole solution but are a necessary step at this point in the pandemic.

"Most developing countries have well-established immunization programs that can be leveraged to tackle global pandemics," said Ali, associate professor in the department of epidemiology and biostatistics and a Canada Research Chair in Public Health Economics. "However, these programs are chronically underfunded and have persistent inequalities. This is where Canada, and the Global North, also need to think beyond vaccine supply."